Bupivacaine hydrochloride is a Medicine belongs to Local anaesthetics group whose information about Brand can be referenced from   Book : Martindale    Page : 1982   Edition : 38,

  ►   Brandname : Anawin,Bupivan,Marcain,Marcaine,Bucain

  ►  Strength : Injection with 0.25  %, Injection with 0.5  %, Injection with 0.75  %,

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 463   Edition : 12,
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : IV,
Reference :-   Book : Martindale    Page : 2017   Edition : 37,

Dosing of Medicine differ in Adult & Pediatrics ↓


Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 Surgical anaesthesia Local 0.25 % Injection It is given by infiltration; up to the max. single dose of 150 mg. When a longer duration of anaesthesia is required, as in dental or surgical procedures of the maxillary and mandibular area, a 0.5% solution with adrenaline 1 in 200 000 has been used but a total dose of 90 mg (18 mL) should not be exceeded over a single dental sitting.
2 Peripheral nerve block Local 12.5 mg Injection The usual dose is 12.5 mg (5 mL) as a 0.25% solution or 25 mg (5 mL) as a 0.5% solution, and doses up to the maximum single dose of 150 mg may also be given. A 0.75% solution has been used for retrobulbar block in ophthalmic surgery in a dose of 15 to 30 mg (2 to 4 mL).
3 Sympathetic nerve block Local 50 125 mg Injection Given in 50 to 125 mg (20 to 50 mL) as a 0.25% solution.
4 Lumbar epidural block in surgery Local 25 50 mg Injection A test dose of bupivacaine, preferably with adrenaline, should be given before starting epidural block to detect inadvertent intravascular injection. Subsequent doses should be given in small increments. It is given as 0.25% solution in dose of 25 to 50 mg (10 to 20 mL) or as a 0.5% solution in a dose of 50 to 100 mg (10 to 20 mL). A 0.75% solution is also used for induction of lumbar epidural block in non-obstetric surgery in a single dose of 75 to 150 mg (10 to 20 mL). For caudal block in surgery 37.5 to 75 mg (15 to 30 mL) as a 0.25% solution or 75 to 150 mg (15 to 30 mL) as a 0.5% solution may be used.
5 Spinal block Local 10 20 mg Injection Hyperbaric solutions of bupivacaine without adrenaline may be used for spinal block. Preparations containing 0.5% are available and are given in doses of 10 to 20 mg (2 to 4 mL).
6 Management of acute pain Local Injection Given as an epidural bolus or by continuous infusion. For analgesia during labour, doses of 15 to 30 mg (6 to 12 mL) as a 0.25% solution or 30 to 60 mg (6 to 12 mL) as a 0.5% solution have been recommended as a bolus for lumbar block. Bupivacaine may also be given as a bolus caudal injection for labour pain; doses of 25 to 50 mg (10 to 20 mL) as a 0.25% solution or 50 to 100 mg (10 to 20 mL) as a 0.5% solution are recommended.
7 Postoperative pain Local Injection For postoperative pain bupivacaine may be given as an epidural infusion in doses of 4 to 15 mg (4 to 15 mL) per hour as a 0.1% solution or 5 to 15 mg (4 to 12 mL) per hour as a 0.125% solution. For bunionectomy, a single dose of 106 mg (8 ml) is given: 7 ml into the tissues surrounding the osteotomy and 1 ml into the subcutaneous tissue. For haemorrhoidectomy, a single dose of 266 mg (20 ml) is diluted to 30 ml with preservative-free nacl 0.9% for injection and infiltrated around the anal sphincter in 6 equally divided portions.

Ref :-  Book : Martindale    Page : 1981   Edition : 38,




Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  

Ref :- Book :
►  Side Effect : tinnitus, Dizziness, paresthesia, tremor, Somnolence, hypotension, Skin irritation, constipation, cardiac and respiratory arrest, Arrhythmias, decreased myocardial contractility, methemoglobinemia, seizure, Cardiotoxicity at higher concentrations,
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 161   Edition : 3,

►  Drug Interaction : Drug interaction of Bupivacaine hydrochloride is with Antiarrhythmics, Tricyclic antidepressants,  Suxamethonium/Succinylcholinechloride (Suxamethonium chloride) , Epinephrine (adrenaline) ,
Ref :-   Book : Martindale    Page : 1979   Edition : 38,


  ►    Mechanism of Drug Drug Interaction :  The amide local anaesthetic may competitively enhance the neuromuscular blocking activity of suxamethonium. There is an increased risk of myocardial depression when amide-type local anaesthetics such as bupivacaine is given with antiarrhythmics. If local anaesthetics containing adrenaline are given for epidural or paracervical block during labour the use of an oxytocic drug post partum may lead to severe hypertension. Although there is no clinical evidence of dangerous interactions between adrenaline-containing local anaesthetics and MAOIs or tricyclic antidepressants, great care should nevertheless be taken to avoid inadvertent intravenous doses of the local anaesthetic preparation.,
Ref :-   Book : Martindale    Page : 1979   Edition : 38,


►  Contraindication : contraindicated for use in spinal anesthesia in the presence of septicemia, severe hemorrhage, or arrhythmias such as complete heart block, shock, local infection at the proposed site of spinal anesthesia,
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 161,162   Edition : 3,
  ►  Mechanism of Action :   The primary mechanism of action of local anesthetics is blockade of voltage-gated sodium channels.,
Ref :-   Book : Basic & Clinical pharmacology    Page : 453   Edition : 12,

Pathway of Dietry Product


​   ► Act.Comp / Nutrient / Food / Herb as follows :- NA


Dietry Substance Interactions


​   ► This Medicine interact with :- NA



ContraIndication Dietry Substance


​   ► This Medicine contraindicate with :- NA

►   Route of Elimination :   Renal, Hepatic (Metabolism),
Ref :-   Book : Martindale    Page : 2016   Edition : 37,


►    Plasma Half-life :
  Min value :-   1.5 hours,    Max value :-   5.5 hours,
Ref :-   Book : Martindale    Page : 2016   Edition : 37,

►    Peak Plasma Concentration :   Min value :-   nf,    Max value :-   NA
Ref :-   Book :    Page :    Edition : ,